• Case Manager RN- Field

    Somatus (Miami, FL)
    …going into homes + Telephonic case management experience + Experience working within a managed care environment Other Duties Please note this job description is ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the...Case Managers are an important part of the interdisciplinary care team. They are responsible for outreaching and scheduling… more
    Somatus (12/12/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Tallahassee, FL)
    …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...performance metrics, and identify opportunities for improvement in patient care and clinical practices.** **Value-Based Care Model:… more
    Centene Corporation (12/11/25)
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  • Utilization Management Nurse Consultant

    CVS Health (Tallahassee, FL)
    …years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (12/06/25)
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  • Quality Improvement RN - New Smyrna/Daytona

    CenterWell (New Smyrna Beach, FL)
    …applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual; ... many other opportunities. **About Us** About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive,...Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors,… more
    CenterWell (10/16/25)
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  • Clinical Research Analyst, Senior - Remote

    Prime Therapeutics (Tallahassee, FL)
    …+ Advanced clinical training or certifications + Previous clinical experience in a managed care , pharmaceutical, or PBM environment + Experience working with ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...data to support projects and initiatives throughout the Integrated Care & Specialty, Sales, and Marketing departments + Works… more
    Prime Therapeutics (12/11/25)
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  • Senior Oncology Account Specialist Genitourinary…

    Pfizer (Orlando, FL)
    …thought leaders or high influence customers in hospitals, large group practices or managed care organizations. + A demonstrated track record of success and ... responsibilities, ranging from promoting Pfizer's product portfolio to health care providers and specialists, to educating members of the...products, as well as the overall quality of patient care delivered. The SOAS plays a critical role in… more
    Pfizer (12/11/25)
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  • Business Strategy Plan Director- MedEx Management

    Elevance Health (Miami, FL)
    …Financial, Business, and Leadership acumen strongly preferred. + Prior experience with managed care , trend & healthcare analytics, provider networks, claims, ... the future. + Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation… more
    Elevance Health (12/10/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Tampa, FL)
    …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to… more
    Molina Healthcare (12/07/25)
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  • Senior Compliance Analyst - Remote

    Prime Therapeutics (Tallahassee, FL)
    …projects simultaneously. + Strong analytical skills **Preferred Qualifications** + Pharmacy services, PBM, managed care or health care industry experience + ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...industry, including experience with Medicare, Medicaid, and the Affordable Care Act (ACA) + Must be eligible to work… more
    Prime Therapeutics (12/04/25)
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  • Profee Coder Surgical Urology

    Banner Health (FL)
    …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... Banner Health the best place to work and receive care . We are looking for a motivated, experienced **Profee...for contributing to our award-winning patient care . POSITION SUMMARY Evaluates medical records, provides clinical and… more
    Banner Health (11/26/25)
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